Clinical Dilemma in the Treatment of a Patient with Microangiopathic Haemolytic Anaemia, Thrombocytopaenia and Severe Hypertension

While haemolytic uraemic syndrome in children is predominantly associated with Shiga toxin -producing Escherichia coli (typically 0157:H7), some cases occur without associated diarrhoea, or as the manifestation of an underlying disorder other than infection. Haemolytic uraemic syndrome is characterised by microangiopathic anaemia, thrombocytopaenia and renal failure, on occasion accompanied by severe hypertension. Malignant hypertension is a syndrome that sometimes exhibits the same laboratory abnormalities as haemolytic uraemic syndrome as it may share the same pathological findings: thrombotic microangiopathy. As clinical features of both entities overlap, the distinction between them can be very difficult. However, differentiation is essential for the treatment decision, since early plasma exchange dramatically reduces mortality in haemolytic uraemic syndrome not associated with diarrhoea. An increasing number of genetic causes of this pathology have been described and may be very useful in differentiating it from thrombotic microangiopathy due to other aetiologies. Despite advances in the understanding of the pathophysiology of haemolytic uraemic syndrome not associated with diarrhoea, the management often remains empirical. We describe a patient with simultaneous microangiopathic haemolytic anaemia, thrombocytopaenia and severe hypertension managed in the acute period of illness with plasma exchange

Calagem e parcelamento da adubação fosfatada em porta-enxertos de seringueira.

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Marine 5-thiohistidines as protective molecules from skin damage

Introduction Marine environment is a great source of bioactive molecules, whose biological properties and applications are often used especially to prevent skin diseases and aging caused by UVA­exposure. Ovothiols are methyl­5­thiohistidines from marine invertebrates, bacteria, and microalgae, which protect cells from environmental stressors. Recently, we have shown that, ovothiol, isolated from sea urchin eggs, exerts anti­inflammatory and antioxidant activities on human endothelial cells, and exhibits antifibrotic effect in an in vivo model of liver fibrosis.info:eu-repo/semantics/publishedVersio

Metal abundances and kinematics of quasar absorbers.- I. Absorption systems toward J2233-606

The metal line profiles of different ions observed in high HI column density systems [N(HI) > 10^{16} cm^{-2}] in quasar spectra can be used to constrain the ionization structure and kinematic characteristics of the absorbers. For these purposes, a modified Monte Carlo Inversion (MCI) procedure was applied to the study of three absorption systems in the spectrum of the HDF-South quasar J2233-606 obtained with the UVES spectrograph at the VLT/Kueyen telescope. The MCI does not confirm variations of metal abundances within separate systems which were discussed in the literature. Instead, we found that an assumption of a homogeneous metal content and a unique photoionizing background is sufficient to describe the observed complex metal profiles. It was also found that the linear size L and the line-of-sight velocity dispersion sigma_v measured within the absorbers obey a scaling relation, namely, sigma_v increases with increasing L, and that metal abundance is inversely proportional to the linear size of the system: the highest metallicity was measured in the system with the smallest L.Comment: 10 pages, 7 ps figures, accepted to A&

The optical-ultraviolet continuum of Seyfert 2 galaxies

This paper aims to understand the continuum of Seyfert 2 galaxies. By fitting the single galaxies in the sample of Heckman et al. (1995) with composite models (shock+ photoionization from the active center), we show that five main components characterize the SED of the continuum. Shocks play an important role since they produce a high temperature zone where soft X-rays are emitted. We show that in the optical-UV range, the slope of the NLR emission reproduces the observed values, and may be the main component of the featureless continuum. The presence of star forming regions cannot be excluded in the circumnuclear region of various Seyfert galaxies. An attempt is made to find their fingerprints in the observed AGN spectra. Finally, it is demonstrated that multi-cloud models are necessary to interpret the spectra of single objects, even in the global investigation of a sample of galaxies.Comment: 26 pages, LaTeX (including 5 Tables) + 17 PostScript figures. To appear in "The Astrophysical Journal

The prognostic value of abnormal coagulation times in dogs that are at the risk of developing sepsis

Introduction: Sepsis is a hard to define syndrome associated with a deleterious systemic inflammatory response that ultimately leads to coagulopathy, organ dysfunction, and death. The primary aim of this prospective study was to evaluate if coagulation times can be predictive of disease severity and outcome in patients at risk of developing sepsis.A secondary objective was to correlate activated partial thromboplastin time (aPTT) and prothrombin time (PT) with the quick sequential organ failure assessment (qSOFA) scoring system at the moment of admission to the intensive care unit (ICU) and evaluate their combined prognostic value. The main hypothesis of the study was: Are aPTT and PT correlated with disease severity and outcome, when associated with the qSOFA score, at the moment of admission to the ICU? Methods: A total of 43 dogs were prospectively enrolled in the study between September 2016 and March 2017. Patients that were hemodynamically altered with clinical signs of coagulopathy, infection, shock, or SIRS were included, as well as those affected by polytrauma, organ dysfunction, or neoplasia, upon presentation. These patients had at least one of these clinical signs but some had more than one. Regarding the presence of coagulopathies, all alterations in coagulation times were included. All these patients were susceptible to subclinical infections and bacterial translocation, therefore being at risk of developing sepsis. Coagulation testing and qSOFA scoring were performed at the time of admission to the ICU and were statistically analyzed using tests such as Chi-square tests, T-tests, ANOVA, HSD tests, and Pearson correlation coefficient tests. Other variables such as signalment, diagnosis, duration of hospitalization and post-discharge treatment and outcome were also recorded and analyzed. Results: Mortality rate was 34.9%. Mortality increased with the number of qSOFA points (0 points: 10%; 1 point: 30.8%; 2 points: 47.1%; 3 points: 66.7%). The aPTT was significantly higher (p = 0.029) in patients with a qSOFA score of 2 points in comparison to those with 1 point. A positive correlation was found between aPTT and PT (r = 0.406, n = 43, p = 0.005). Mean values for aPTT and PT were similar between surviving and non-surviving patients. Ten out of 15 patients (66.7%) that died did so between the first and fifth day of treatment, and 3 of the remaining 5 deaths (60%) were caused by neoplastic disease. Causes of dead included gastrointestinal disease, infectious disease,urinary tract disease, trauma, autoimmune disease, neurological disorder and neoplasia. Conclusions: The results of this study suggest the existence of hemostatic dysfunction amongst patients with a qSOFA score of 2 points. In isolation, however, prolonged coagulation times at ICU admission were not predictive of outcome

Efeito da adubação mineral na produção de matéria seca de pimenta longa (Piper hispidinervium).

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